Contact Information
Position Applying For:
Position desired
Full Time/Part Time Full Time Part Time
Salary Requirement
Applicant Eligibility
Are you 18 years of age or older? Yes No
If no, do you have a work permit? Yes No Does Not Apply
Are you a US Citizen? Yes No
If no, what type of work permit do you have?
If hired, can you provide proof that you are eligible to work in the United States? Yes No
Have you ever been arrested? Yes No
Have you ever been convicted of a felony? Yes No
Have you ever been convicted of a misdemeanor? Yes No
If yes to any above, list all convictions, offenses, or pending charges.
Educational Background
High School
Year Started Yes No
College
Year Started Yes No
Work History
Employer 1
I am currently employed here Yes No
Start Date
Employer 2
I am currently employed here Yes No
Start Date
Submission
Date of Submission:
How did you hear about us? —Please choose an option— Word of Mouth Internet Search Online Directory Listing Banner Ad Video Ad Other
Additional Notes
I understand that all of the above information is true and that falsification of any information on this application is grounds for termination. I also understand that I must be available for employment between the hours of 7:30am-5:30pm, Monday-Friday and Saturdays if needed.
I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for ACS Company to hire me. If I am hired, I understand that either ACS Company or I can terminate my employment at any time and for any reason, with or without cuase, and withour prior notice. I understand that no representative of ACS Company has the authority to make any assurance to the contrary. I authorize ACS Company to contact any references provided throughout my application process. If any information I have provided is untree, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal.
Check this box if you agree
